RESUMO
OBJECTIVE: To describe the use of dental floss by teenagers and study associations between flossing and approximal caries experience, oral health behaviours, gender, parental education and national background. METHODS: The study included 2156 14-year-old teenagers. Data were collected in conjunction with routine dental examinations. Teenagers answered a questionnaire about frequency of and reasons for flossing, oral health behaviours and family characteristics. Information about approximal enamel (D1â2Sa) and dentine caries experience (D3MFSa) was collected from dental records. Data were cross-tabulated and tested with Chi-Square statistics and ANOVA, and analysed using multivariable logistic regression. The data was baseline data in a longitudinal study exploring effects of dental floss. The study was performed as part of the quality assurance system required by law in the dental services and did not require ethical approval. RESULTS: Half of the teenagers (54%) used dental floss. Among teenagers who flossed, 15% reported doing so daily. Recommendation from dental personnel was the most important reason for using dental floss. Proportionately more girls and teenagers whose parents had high educational achievement reported flossing. Teenagers who flossed more often had more favourable oral health behaviours than other teenagers but more often had approximal enamel caries (D1â2Sa) and approximal dentine caries experience (D3MFSa) than other teenagers (p⟨0.05). CONCLUSION: Use of dental floss was not a daily behaviour in most teenagers. Flossing was associated with having approximal caries lesions, indicating that teenagers having signs of approximal caries had been recommended to use dental floss.
Assuntos
Cárie Dentária , Dispositivos para o Cuidado Bucal Domiciliar , Adolescente , Cárie Dentária/prevenção & controle , Feminino , Humanos , Estudos Longitudinais , Saúde BucalRESUMO
Objective: To explore caries development in children from 5 to 12 years of age, and to study whether enamel caries and dentine caries at 5 years of age could predict caries prevalence at 12 years of age, controlled for child characteristics.Methods: The study included 3282 children examined at 5 and 12 years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved.Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5 years of age had at 12 years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p < .05). Dentine caries experience at 12 years of age was associated with having only enamel caries (OR 1.6, CI 1.2-2.0) and dentine caries experience (OR 3.2, CI 2.6-3.9) at 5 years of age. Family status and parental education were related to caries development.Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment.
Assuntos
Cárie Dentária , Criança , Pré-Escolar , Índice CPO , Cárie Dentária/epidemiologia , Esmalte Dentário , Dentina , Humanos , Estudos Longitudinais , Prevalência , Estudos Prospectivos , Dente DecíduoRESUMO
OBJECTIVE: The purpose of the present study was to explore intervals between regular dental examination and the time dentists spent for examination and preventive dental care of children in 1996 and 2014. PARTICIPANTS AND METHODS: In Denmark, Norway and Sweden, random samples of dentists working with children were included, while in Iceland all dentists were mailed questionnaires. Complete information was provided by 1082 of 1834 dentists (64%) in 1996 and 1366 of 2334 dentists (59%) in 2014. Results were assessed using chi-square and analysis of variance with post-hoc tests. RESULTS: Some trends were consistent in all countries, but considerable differences in routines between the countries persisted during the period. The most used and maximum planned recall intervals were on average 14.8 (sd 4.8) and 18.5 (sd 4.6) months in 2014, respectively 3.1 and 3.5 months longer than in 1996 (p⟨0.05). In 2014 dentists used ample time delivering preventive care to children. Dentists reported spending significantly more time providing preventive care for caries risk children than for other children both in 1996 and 2014. Concurrent with extended intervals, dentists reported spending longer performing routine examinations in three of the four countries in 2014 than in 1996. CONCLUSIONS: This study of trends in dental care delivered by dentists during recent decades showed moves towards extended recall intervals and preventive care individualized according to caries risk. In addition, extending intervals could necessitate more time for a routine dental examination.
Assuntos
Assistência Odontológica para Crianças/tendências , Padrões de Prática Odontológica , Adulto , Agendamento de Consultas , Criança , Dinamarca , Odontólogos , Feminino , Humanos , Islândia , Masculino , Pessoa de Meia-Idade , Noruega , Autorrelato , Suécia , Fatores de TempoRESUMO
Oral health promotion to young children is delivered by primary care nurses as part of general health promotion given to all children in Norway. OBJECTIVE: The objective was to evaluate established routines for referral of children by primary care nurses to the dental services and to study whether referred children younger than 3 years required contact with dental personnel. METHODS: All children referred by primary care nurses to the dental services in one county during one year were included. Primary care nurses referred children using criteria developed by dental personnel. At the dental clinic, anamnestic information, dental health and oral health behaviour of the referred children were registered. RESULTS: Altogether, 181 children were referred; 53% were younger than 3 years. The most frequent reasons for referral of children younger than 3 years were caries or dental plaque, and 34% had visible plaque accumulation and/or visible signs of caries. All referred children had at least one risk factor for caries. The referral reasons given by primary care nurses corresponded partly with findings at dental examination. The results indicated that 2% of the children younger than 3 years were referred to the dental services. CONCLUSION: The results indicated that by using established referral routines, all children referred from well-baby clinics to the dental services were caries risk children who required early contact with dental personnel. However, the low proportion of children in the studied population referred by primary care personnel may indicate under-referral of children to the dental services.
Assuntos
Assistência Odontológica , Cárie Dentária/terapia , Placa Dentária/terapia , Enfermagem de Atenção Primária , Encaminhamento e Consulta , Criança , Pré-Escolar , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Promoção da Saúde , Humanos , Noruega , Fatores de RiscoRESUMO
BACKGROUND: Recommendations regarding caries-preventive self-care for children are provided by several health authorities. OBJECTIVE: To investigate recommendations given to the public regarding children's caries-preventive self-care by Norwegian dentists, dental hygienists, dental nurses and public health nurses. METHODS: Questionnaires were sent by e-mail and answered by 808 of 1132 persons who provide oral preventive promotion to children in dental services and health centres. The preventive advice was obtained through questions about the preferred preventive methods, fluoride recommendations and sources of knowledge on which the personnel based the advice about caries prevention in children. The responses were analysed using logistic regression. RESULTS: The majority (59-71%) in all professions judged oral hygiene education to be the most important caries-preventive method. Most personnel (84-98%) recommended all children to use fluoride toothpaste, and half of all personnel (53%) recommended fluoride lozenges for 50% or more of children. Multivariate analysis showed that dental nurses recommended lozenges to more children than dentists (OR 2.5, 95% CI 1.7-3.7), while health nurses recommended lozenges to fewer children than dentists (OR 0.5, 95% CI 0.3-0.8). The most important source of knowledge reported by dental personnel was professional education, while health nurses relied on information from dental personnel. CONCLUSIONS: Health professions' recommendations regarding caries-preventive self-care for children were mainly similar, although variation existed both between and within professions. Collaboration between professions and awareness of the evidence base for preventive oral care may improve the consistency of information given by health professionals to the public.
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Cárie Dentária/prevenção & controle , Educação em Saúde Bucal , Saúde Bucal/educação , Higiene Bucal/educação , Autocuidado , Adulto , Atitude do Pessoal de Saúde , Criança , Humanos , Noruega , Inquéritos e QuestionáriosRESUMO
UNLABELLED: In 2008, Iceland experienced a major financial crisis, with serious effects on the economy of the country and its inhabitants. OBJECTIVE: To describe the opinions of dentists in Iceland regarding the influence of economic changes on the demand for dental health services for children and adolescents, aged 0-18 years, and also to describe the preventive dental care the dentists reported providing for children and adolescents. BASIC RESEARCH DESIGN AND PARTICIPANTS: Questionnaires were sent by electronic mail to all dentists in Iceland in January 2013. Of the dentists working with children, 161 (62%) returned the questionnaire. RESULTS: Important findings were that 119 (74%) of the respondents reported increased caries experience in children and adolescents and 150 (93%) reported that decreased reimbursement for dental treatment of children in recent years had affected the dental health of most or some children and adolescents. Most dentists reported reduced parental demand for most aspects of caries prevention and treatment, apart from treatment for acute dental pain. The mean interval between dental visits was reported to be 9.4 months (sd 2.8) and the mean maximal interval 12.1 months (sd 2.8). The mean proportion of working time allocated for caries preventive services was reported to be 31% (sd 21). CONCLUSIONS: The results indicate a contrast between increased need for children's dental care perceived by the dentists and reduced demand for care from the parents. This may be a temporary phenomenon, as the economic crisis passes, reimbursement for dental care may increase.
Assuntos
Atitude do Pessoal de Saúde , Assistência Odontológica para Crianças , Odontólogos/psicologia , Recessão Econômica , Necessidades e Demandas de Serviços de Saúde , Adolescente , Atitude Frente a Saúde , Criança , Pré-Escolar , Índice CPO , Assistência Odontológica para Crianças/economia , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Feminino , Humanos , Islândia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Saúde Bucal , Pais/psicologia , Mecanismo de Reembolso/economia , Odontalgia/terapiaRESUMO
This study aimed to compare the clinical effectiveness of resin-based fissure sealants (FS) and fluoride varnish (FV) in children at high caries risk. A practice-based split-mouth randomized clinical trial was conducted at 9 Public Dental Service (PDS) clinics in Norway. In total, 409 children age 6 to 10 y at high caries risk (d3mft > 0) meeting inclusion criteria were recruited by dentists and dental hygienists during routine examination. Eligibility criteria were 2 fully erupted first permanent molars (FPMs) in the same jaw, with sound occlusal surfaces or with initial caries. Participation was voluntary, caregivers and eligible children were informed about the study, and written parental consent was obtained. FS and FV were randomly applied on contralateral FPMs in the same jaw, with each participant serving as their own control. FS was applied at baseline and thereafter maintained according to clinicians' conventional procedures, whereas FV was applied at baseline, 6 mo, and 12 mo. The study outcome was success, with no need for invasive treatment (caries control), while failure was defined as dentin carious lesion or restoration. Two-level mixed-effects logistic regression analysis was used to compare FS and FV groups. Of 409 recruited children, 369 (90%) children/tooth pairs were examined after 36 mo. Intention-to-treat analysis showed 94.1% adjusted predicted probability (aPP) of success (95% confidence interval [CI] 91.7 to 96.4) in the FS group and 89.6% aPP (95% CI 86.5 to 92.7) in the FV group. In the adjusted analysis, the FV group had a lower OR for success compared with the FS group (OR 0.54, 95% CI 0.24 to 0.87). In the population studied, the clinical effectiveness of FS was statistically significantly higher compared with FV but below the estimated minimal clinically important difference of 10%.
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Cariostáticos , Cárie Dentária , Fluoretos Tópicos , Selantes de Fossas e Fissuras , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Fluoretos Tópicos/uso terapêutico , Cárie Dentária/prevenção & controle , Masculino , Feminino , Criança , Cariostáticos/uso terapêutico , Resultado do Tratamento , Dente MolarAssuntos
Auxiliares de Odontologia , Assistência Odontológica , Cárie Dentária/prevenção & controle , Odontólogos , Promoção da Saúde , Enfermeiras e Enfermeiros , Saúde Bucal , Enfermagem de Atenção Primária , Encaminhamento e Consulta , Fatores Etários , Pré-Escolar , Humanos , Noruega/epidemiologiaRESUMO
With the aim of identifying peritoneal metastasis-related genes in gastric cancer, we performed a broad analysis of differential gene expression between the parental cell line GC9811 and its highly metastatic peritoneal counterpart, cell line GC9811-P. Two fluorescent cDNA probes, labeled with Cy3 and Cy5 dyes, were prepared from GC9811 and GC9811-P mRNA samples by the reverse transcription method. The two color probes were then mixed and hybridized to a cDNA chip constructed with double-dots from 11,901 human genes; this was scanned at two wavelengths. The experiment was repeated twice. In GC9811-P cells, 218 genes were upregulated and 30 genes were downregulated compared with the parental cell lines. Some selected genes were confirmed by RT-PCR and Western blot; we found that S100A4 and CTNNB1 were upregulated and PTEN was downregulated in GC9811-P cells. Identification of these differentially expressed genes could contribute to disclose the molecular mechanisms involved and provide new targets for therapeutic intervention to avoid peritoneal dissemination of gastric adenocarcinoma.
Assuntos
Adenocarcinoma/genética , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Neoplasias Gástricas/genética , Humanos , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
OBJECTIVE: The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health. MATERIAL AND METHODS: A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used. RESULTS: Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P ≤ 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales. CONCLUSIONS: This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life.
Assuntos
Efeitos Psicossociais da Doença , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/psicologia , Saúde Bucal , Qualidade de Vida/psicologia , Adulto , Estudos de Coortes , Índice CPO , Análise Fatorial , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Psicometria , Perfil de Impacto da Doença , Fatores SocioeconômicosRESUMO
PURPOSE: To explore the use of fissure sealing as a caries preventive method by describing characteristics of children who had received sealants and to study associations between sealing and caries prevalence at 12 years of age. METHODS: The study included 3075 children examined at 5 and 12 years of age. Data were collected by clinical examination and questionnaire to parents. The questionnaire provided information on child characteristics and oral health behaviour in children at 5 years of age. Data on sealing and caries prevalence were obtained from dental records. Bi- and multivariate logistic regressions were performed. The Regional Committee for Medical Research Ethics approved the study (2.200.54 and 2013/1881). RESULTS: Of the children, 12% had received sealants on permanent teeth before 12 years of age. Children with dentin caries at 5 years of age (OR 2.0, CI 1.5-2.7) had a higher probability of having received sealants than children without caries. Having sealants (OR 2.8, CI 2.2-3.6), enamel caries (OR 1.5, CI 1.2-1.9), dentin caries (OR 2.9, CI 2.3-3.6) and using fluoride lozenges less than daily (OR 1.5, CI 1.3-1.8) at 5 years of age were associated with having dentin caries prevalence at 12 years of age. CONCLUSION: Few children had received fissure sealing. Although sealing was used as a caries preventive method in children who had experienced caries in primary teeth, these children continued developing caries in their permanent teeth.
Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Criança , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Suscetibilidade à Cárie Dentária , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Dentição Permanente , Noruega/epidemiologiaRESUMO
AIM: To investigate the influence of low androgen levels and high-fat diet on the structure of pituitary and penis in male rats. METHODS: Ten-week-old adult male Sprague-Dawley rats were randomly divided into 2 groups, one fed a high-fat diet the other fed a normal diet; each group consisted of 3 subgroups: controls, castrated rats (with low androgen), and castrated rats given undecanoate replenishment. After 11 weeks, the structure of pituitary and penis were observed under light microscopy. Immunohistochemistry was used to assess the expression of FSH in pituitary and cyclooxygenase-2 (COX-2) in corpora cavernosa penis. RESULTS: The structures of pituitary and penis in castrated rats were injured, and were more damaged in castration together with high-fat diet. Immunohistochemistry showed FSH expression in castrated rats pituitary while castrated rats on a high-fat diet had less positive staining than those on a normal diet. Vascular structure of corpora cavernosa penis, showed a strongly positive COX-2 expression in high-fat diet rats. CONCLUSIONS: Castration and high-fat diet could induce structural damages of pituitary and penis in male rats. Replacement with testosterone could partially restore the impaired structure. The positive expression of COX-2 implied inflammatory pathway existence on vascular structure of penis in high-fat diet and low-androgen male rats.
Assuntos
Castração , Gorduras na Dieta , Pênis/anatomia & histologia , Pênis/patologia , Hipófise/anatomia & histologia , Hipófise/patologia , Animais , Peso Corporal , Ciclo-Oxigenase 2/metabolismo , Estrogênios/sangue , Hormônio Foliculoestimulante/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/efeitos dos fármacos , Pênis/metabolismo , Hipófise/efeitos dos fármacos , Hipófise/metabolismo , Ratos , Ratos Sprague-Dawley , Testosterona/sangue , Testosterona/farmacologiaRESUMO
AIMS: To investigate whether rosiglitazone (ROS) protects diabetic rats from destructive changes in the liver. METHODS: Twenty-four Sprague Dawley rats were randomly divided into 3 groups: control (NC) group (no.=8), streptozocin (STZ)-treated diabetic (DM) group (no.=8), and STZ+ROStreated diabetic (RSG) group (no.=8). After 8 weeks, the liver structure was observed by light microscopy and transmission electron microscopy. Apoptosis was detected by TUNEL, and apoptosis index was calculated. The Fas ligand (FasL) mRNA expression of apoptosis-promoting gene and cyclooxygenase- 2 (COX-2) mRNA in the liver were detected by RTPCR. COX-2 protein in the liver was tested via immunohistochemical staining. RESULTS: Compared to NC group, DM group showed a visible fatty degeneration and inflammatory cell infiltration in the liver under microscopy. Obvious hepatocyte swelling with atrophic mitochondria was observed, and the central zone of cholangiole was severely outstretched. Meanwhile, in RSG group, the hepatocyte steatosis and inflammatory cell infiltration decreased, and the hepatic ultra-structure was markedly improved. Hepatocyte apoptosis (p<0.05) and the expression levels for hepatic COX-2 mRNA (p<0.05), FasL mRNA (p<0.01), and COX-2 protein (p<0.05) were higher in DM group compared to the NC group, while the expression level of hepatic COX-2 mRNA (p<0.05), FasL mRNA (p<0.01), COX-2 protein (p<0.05), and hepatocyte apoptosis (p<0.05) in RSG group were decreased compared to DM group. CONCLUSION: Diabetes causes severe liver injury and ROS can protect diabetic rats from liver destruction, which may be related to inhibition of the expression of COX-2 and the hepatocyte apoptosis induced by FasL gene over expression.
Assuntos
Diabetes Mellitus Experimental/complicações , Hepatopatias/prevenção & controle , Tiazolidinedionas/uso terapêutico , Animais , Apoptose , Ciclo-Oxigenase 2/biossíntese , Ciclo-Oxigenase 2/genética , Proteína Ligante Fas/biossíntese , Proteína Ligante Fas/genética , Fígado Gorduroso/etiologia , Marcação In Situ das Extremidades Cortadas , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , RosiglitazonaRESUMO
Dental health has mostly been measured by dental staff disregarding patient's experiences. However, clinical conditions alone do not fully indicate how people feel affected by their oral status. The aim of this study was to investigate how clinical recorded dental health, self-rated dental health, satisfaction with dental health were related to oral health-related quality of life (OHRQoL) assessed by Oral Health Impact Profile (OHIP-14) in 68-77 years old. A total of 151 individuals completed a questionnaire on self-rated dental health, satisfaction with dental health and the short form of OHIP-14. Clinical examination was performed registering number of teeth and dental caries. In total 63% of the individuals rated their dental health as good, and 59% were satisfied with their dental health. Using the OHIP-14 42% reported no problems or oral discomfort at all. The proportion of individuals reporting problems or discomfort varied between 13% and 43% according to the dimensions of OHIP-14. The most frequently reported problems were physical pain (43%), psychological discomfort (28%) and psychological disability (28%). Individuals who rated their dental health as poor and those who were dissatisfied with their dental health had significantly lower OHRQoL than other individuals. The study showed relationship between self-evaluations of dental health and OHRQoL in 68-77 years old. Individuals with few teeth reported lower OHRQoL than others, but no association between clinical caries status and OHRQoL could be found.
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Nível de Saúde , Doenças da Boca/psicologia , Saúde Bucal , Qualidade de Vida/psicologia , Atividades Cotidianas , Idoso , Estudos de Coortes , Feminino , Avaliação Geriátrica , Humanos , MasculinoRESUMO
Objective: To determine the correlation between the diabetes mellitus control and periodontitis. Methods: This study was a cross-sectional survey using stratified system sampling model design. The target population was the patients with diabetes investigated from May to July 2018 in Huangpu District of Shanghai. In the present study, severe periodontitis was defined as at least at two sites in different quadrants with probing depth (PD)≥6 mm and clinical attachment loss (CAL)≥ 5 mm. Edentulous induced by periodontitis were also classified as severe periodontitis and the others were classified as non-severe periodontitis subjects. Diabetes control levels were divided into the following three groups: poorly controlled group [glycated hemoglobin (HbA1c)>7.5% and fasting blood glucose (FPG)>7.0 mmol/L], well controlled group (6.5%≤HbA1c≤7.5ï¼ or 6.1 mmol/L≤FPG≤7.0 mmol/L) and ideally controlled group (HbA1c<6.5% and FPG<6.1 mmol/L). SPSS 25.0 was used for statistical analysis. Chi square test was used for demographic data and frequency distribution, α=0.05, two-sided test. Ordinal regression model was used for PD and diabetes control status to balance confounding factors (including age, gender, education and smoking status). After matching the propensity scores between severe periodontitis group and non-severe periodontitis group, logistic regression analysis was used to analyze the level of diabetes control and periodontitis. Results: A total of 5 220 adults over the age of 18 with a medical history of diabetes participated in the survey, of which 3 064 subjects with diabetes mellitus type 2 (T2DM) who were given both oral and laboratory examinations and were included in this study. Statistics showed that the prevalence of moderate and severe periodontitis was 10.57% (324/3 064). In the severe periodontitis group, 79.01% (256/324) of the subjects were over 65 years old, 55.56% (180/324) were male, 58.33% (189/324) had lower education level than high school level, and 21.91% (71/324) were smokers, which were significantly higher than those in the non-severe periodontitis group (P<0.01). In different T2DM status groups, the percentage of severe periodontitis increased with the aggravation of T2DM status. In severe periodontitis group, the proportion of patients with poor glycemic control was higher. T2DM patients with poor glycemic control accounted for 68.52% (222/324) in severe periodontitis group, which was significantly higher than the proportion of non-severe periodontitis group of 60.99% (1 671/2 740) (P<0.05). The regression coefficient of PD was 0.191, and PD had a significant negative effect on the level of blood glucose (P<0.01). There was a significant positive correlation between diabetes glycemic control and severe periodontitis (OR=2.800, P<0.05). Conclusions: In Huangpu District of Shanghai, among T2DM patients, the age of severe periodontitis group was higher than that of non-severe periodontitis group, most of them were male, with lower education level and higher proportion of smoking. The severity of diabetes was related to periodontitis and the proportion of severe periodontitis was higher in patients with poor glycemic control.
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Diabetes Mellitus Tipo 2 , Periodontite , Adulto , Idoso , Glicemia , China , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Hemoglobinas Glicadas , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/complicaçõesRESUMO
BACKGROUND: Chromosome 15q11-13 contains a cluster of imprinted genes essential for normal mammalian neurodevelopment. Deficiencies in paternal or maternal 15q11-13 alleles result in Prader-Willi or Angelman syndromes, respectively, and maternal duplications lead to a distinct condition that often includes autism. Overexpression of maternally expressed imprinted genes is predicted to cause 15q11-13-associated autism, but a link between gene dosage and expression has not been experimentally determined in brain. METHODS: Postmortem brain tissue was obtained from a male with 15q11-13 hexasomy and a female with 15q11-13 tetrasomy. Quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to measure 10 15q11-13 transcripts in maternal 15q11-13 duplication, Prader-Willi syndrome, and control brain samples. Southern blot, bisulfite sequencing and fluorescence in situ hybridisation were used to investigate epigenetic mechanisms of gene regulation. RESULTS: Gene expression and DNA methylation correlated with parental gene dosage in the male 15q11-13 duplication sample with severe cognitive impairment and seizures. Strikingly, the female with autism and milder Prader-Willi-like characteristics demonstrated unexpected deficiencies in the paternally expressed transcripts SNRPN, NDN, HBII85, and HBII52 and unchanged levels of maternally expressed UBE3A compared to controls. Paternal expression abnormalities in the female duplication sample were consistent with elevated DNA methylation of the 15q11-13 imprinting control region (ICR). Expression of non-imprinted 15q11-13 GABA receptor subunit genes was significantly reduced specifically in the female 15q11-13 duplication brain without detectable GABRB3 methylation differences. CONCLUSION: Our findings suggest that genetic copy number changes combined with additional genetic or environmental influences on epigenetic mechanisms impact outcome and clinical heterogeneity of 15q11-13 duplication syndromes.
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Aneuploidia , Encéfalo/metabolismo , Cromossomos Humanos Par 15/genética , Epigênese Genética , Dosagem de Genes/genética , Adolescente , Adulto , Síndrome de Angelman/genética , Síndrome de Angelman/metabolismo , Metilação de DNA , Feminino , Duplicação Gênica , Expressão Gênica , Humanos , Masculino , Síndrome de Prader-Willi/genética , Síndrome de Prader-Willi/metabolismo , SíndromeRESUMO
The aim of the study was to evaluate and compare two dental erosive wear scoring systems, the Visual Erosion Dental Examination (VEDE) and Basic Erosive Wear Examination (BEWE). Seventy-four tooth surfaces (photographs) and 562 surfaces (in participants) were scored by 5 (photographs) or 3 (in participants) clinicians using both scoring systems. The surfaces in the photographs were scored twice. The level of agreement was measured by weighted kappa (kappa(w)). Inter- and intraexaminer agreement showed small variations between the examiners for both systems when scoring the photographs. Slightly higher mean kappa(w) values were found for VEDE (kappa(w) = 0.77) compared with BEWE (kappa(w) = 0.69). When scoring the surfaces in the clinical examination the mean kappa(w) values for the two systems were equal (kappa(w) = 0.73). Interexaminer agreement using VEDE was calculated to see how differentiation between enamel and dentine lesions influenced the variability. The highest agreement was found for score 0 (sound, 86%) and score 3 (exposure of dentine, 67%), while the smallest agreement was shown for score 1 (initial loss of enamel, 30%) and score 2 (pronounced loss of enamel, 57%). The reliability of the two scoring systems proved acceptable for scoring the severity of dental erosive wear and for recording such lesions in prevalence studies. The greatest difficulties were found when scoring enamel lesions, especially initial lesions, while good agreement was observed when examining sound surfaces (score 0) and dentine lesions (score 3).
Assuntos
Diagnóstico Bucal/métodos , Erosão Dentária/classificação , Erosão Dentária/patologia , Adolescente , Esmalte Dentário/patologia , Dentina/patologia , Humanos , Variações Dependentes do Observador , Fotografia Dentária , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
UNLABELLED: Skewed caries distribution has made interesting the use of a high risk strategy in child dental services. OBJECTIVE: The purpose of this study was to describe the preventive dental care given and the recall intervals used for children and adolescents in a low caries risk population, and to study how the time spent for preventive care and the length of intervals were associated with characteristics of the children and factors related to care delivery. MATERIAL AND METHODS: Time spent for and type of preventive care, recall intervals, oral health and health behaviour of children and adolescents three to 18 years of age (n = 576) and the preventive services delivered were registered at routine dental examinations in the public dental services. RESULTS: The time used for preventive dental care was on average 22% of the total time used in a course of treatment (7.3 of 33.4 minutes). Less than 15% of the variation in time spent for prevention was explained by oral health, oral health behaviours and other characteristics of the children and the service delivery. The mean (SD) recall intervals were 15.4 (4.6) months and 55% of the children were given intervals equal to or longer than 18 months. Approximately 30% of the variation in the length of the recall intervals was explained by characteristics of the child and the service delivery. CONCLUSIONS: The time used for preventive dental care of children in a low risk population was standardized, while the recall intervals to a certain extent were individualized according to dental health and dental health behaviour.
Assuntos
Agendamento de Consultas , Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/prevenção & controle , Serviços de Saúde Bucal/estatística & dados numéricos , Odontologia Preventiva/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Cárie Dentária/epidemiologia , Cuidado Periódico , Feminino , Comportamentos Relacionados com a Saúde , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Noruega/epidemiologia , Visita a Consultório Médico/estatística & dados numéricos , Fatores de Risco , Fatores de TempoRESUMO
AIM: The aim was to compare the working profiles of Finnish and Norwegian dental hygienists in public and private practice. To this end, we compared the procedures performed, the type of patients and the time devoted to different tasks. SUBJECTS AND METHODS: A questionnaire survey was originally conducted among a representative sample of dental hygienists in Finland (n = 595) and all authorized dental hygienists in Norway (n = 1,138) in 2004. The questionnaires collected data on the dental hygienists' age, gender, year of graduation, working experience, work sector (private or public), working time spent on different activities and patient groups. The questionnaire also assessed how frequently the dental hygienists performed 25 different treatment measures. RESULTS: The Norwegian dental hygienists spent 45.4% of their clinical time on check-ups, whereas the Finns spent 49.9% of their time scaling. Dental hygienists in Finland and Norway working in the public sector spent 42.9% and 74.6% of their working time dealing with children and youth respectively. CONCLUSIONS: The working profiles of dental hygienists in Finland and Norway were quite similar, although differences in distribution by activities, type of patients and treatment measures do exist. The main activity of the dental hygienists was clinical work. The most commonly practised clinical activity among Finnish dental hygienists was scaling, and among Norwegians, check-ups. Public dental hygienists in both countries dealt mainly with children and youths. Oral hygiene instruction was the most commonly reported treatment measure among both Finns and Norwegians.